(Adapted from The Healthy Mind, Healthy Body Handbook by David S. Sobel, MD and Robert Ornstein, PhD, DRx (Box 176, Los Altos, California 94023) May not be reproduced without written permission.

A growing body of evidence now indicates that by preparing yourself
psychologically for surgery, you can enhance your chances of success,
minimize trauma and discomfort, and recover faster. As with a sporting
event, the better prepared you are mentally, the better your body
responds. Here is a look at some of the research along with practical
tips for making it work for you.

Getting ready for surgery is a lot like getting ready for a big
athletic event. You've got to understand the rules of the game, devise
a good game plan, and make sure you're prepared - physically and
mentally. As patients, we tend to feel that our fate is entirely in
the hands of the surgeon and the medical staff. Evidence now
indicates, however, that there's a lot we can do before surgery to
help the process, minimize trauma and discomfort, and recover faster.
As with a sporting event, the better prepared you are mentally, the
better your body responds.

Researchers analyzed the results of over 190 studies of mental
preparation for surgery and found that 80% of the patients showed
significant benefits: quicker recovery, fewer complications, less post
surgical pain, less need for pain medication, less anxiety and
depression, and an average of 1.5 fewer days in the hospital.

You can take advantage of these findings by making and following your own plan for psychological preparation. Doctors are fond of saying "the way a patient goes into anesthesia is the way a patient will come out." It certainly seems true that those who feel relaxed, optimistic, and in control are likely to feel better and recover faster than those who feel highly anxious and vulnerable.

The best way for you to reduce the stress of surgery depends somewhat on your own coping style and on how much information and involvement you prefer. In this article you'll find a wide range of suggestions on how to prepare for surgery. Pick and choose the ones that feel right to you.

Believe You Need It
Americans are the most operated-on people in the world. More than 50 million surgeries are performed in this country each year and not all of these operations are really necessary. Only about 20% are in response to an emergency such as a severe injury; 80% are "elective," meaning that the patient can choose when and where to have the operation, if at all. The numbers of operations performed varies widely from country to country, state to state, city to city, and even from surgeon to surgeon. In fact, the best indicator of the amount of surgery in a given community is the number of surgeons in the community, not the prevalence of disease! The more surgeons, the more surgery.

Even the rates of surgery for a given condition can vary widely within a community. One study showed that the rates of hysterectomy (removal of the uterus) were four times higher in one town than the one next to it.
Given all this, the very first step in getting yourself psychologically ready for surgery may to be more confident that it's the right course for you. When surgery is recommended for you or a family member, ask questions. If you have doubts, get a second opinion. See the suggestions in the box on page 3.

Make the Operation
"Your Own."
This is your operation. Make sure that you receive the support you need. A hospital can be a confusing and insensitive environment. It's appropriate to ask directly and repeatedly for what you need, whether it is a blanket, a pain medication, information, or someone to hold your hand.

David S. Sobel, M.D., M.P.H., is a practicing physician in adult medicine and Medical Director of Patient Education and Health Promotion for Kaiser Permanente Northern California. He is physician lead for the......more

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